Letter: Pioneers and victims of care in the community

Sir: While supporting the general thrust of your editorial on the Clunis case (19 July), I must take issue with you for perpetuating the myth that psychiatric bed closures were initially forced by external critiques. When Irving Goffman's Asylums was published in 1961, mental hospital beds in this country had been closing for seven years. By the time One Flew Over the Cuckoo's Nest was released in the early 1970s, 40,000 beds had closed out of an all-time high, in 1954, of 144,000.

The reduction in psychiatric bed numbers was initiated by psychiatrists and their patients who realised that, with the new treatments available, fewer people actually needed to be in hospital. Moreover, these changes were far in advance of those in other industrialised nations.

The subsequent political enlistment of the process of bed-closure to mask health service under-funding should not detract from the achievements of those early pioneers of more humane and effective psychiatric care.

Yours faithfully,

PHILIP TIMMS

London, SE1

20 July

The writer is a senior lecturer in community psychiatry, Guy's & St Thomas's UMDS.